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here are 10 important factors for slowing down cardiovascular ageing and promoting healthy ageing of the heart, according to a new summary published in the European Heart Journal.

Most of those factors are well-known; however, the effects of stress and our social and emotional health are rarely mentioned in relation to heart health. They may be key in promoting healthy ageing of the heart.

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We can dramatically reduce the likelihood of cardiometabolic diseases – and any chronic disease – by following these 10 steps.
We can dramatically reduce the likelihood of cardiometabolic diseases – and any chronic disease – by following these 10 steps.
© iStock
We’ve heard about the importance of consuming a primarily plant-based, fibre-rich diet enriched with fish and some dairy products. It provides the fatty acids, fibre, vitamins, minerals and phytochemicals that underpin our body’s metabolic and molecular function. With good nutrition, growing evidence suggests time-restricted eating, in a window of eight to 10 hours, can enhance weight management and metabolic health.
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We also know that we ought to be moving for 30 to 60 minutes a day, mixing up aerobic, high-intensity interval training, strength, flexibility, and balance training, to reduce visceral fat and help maintain glucose metabolism, insulin sensitivity and blood pressure, while regular three- to five-minute breaks from prolonged sitting can further enhance these effects.

Smoking sucks the health right out of our hearts because it leads to inflammation, endothelial dysfunction and chronic sympathetic nervous system activation (our body’s stress response), while drinking alcohol, even in small amounts, is not beneficial to heart health.

Exposure to air pollution (which can be mitigated by masks, closed car windows, and air-conditioning, as well as exercising in green spaces) has a similar effect on the body as smoking, some evidence suggests.

Prioritising sleep is another key factor because poor sleep quality contributes to chronic inflammation, insulin resistance, increased sympathetic activity, and hormone disruption, including leptin and ghrelin.

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But, why, despite knowledge about what we ought to be doing, do most people struggle to do it?

When Luigi Fontana, a professor of Medicine and Nutrition and the author of the new paper, began practising medicine and researching healthy ageing, he focused on energy restriction because it was the most powerful intervention to extend the lifespan of animals.

As his experience grew, and he conducted studies, he discovered it wasn’t quite as simple as telling patients that they could be healthier and live longer if they ate less or moved more. Only a percentage of people would ever stick with the healthy changes they were prescribed.

Fontana, the scientific director of the University of Sydney’s Charles Perkins Centre, has become more convinced that the missing piece of the puzzle is the effects of stress and our social and emotional health.

“If people are unhappy, they are distressed, they have anxiety, they are unhappy with their lives, they are going to struggle to change their lifestyle,” says Fontana. “Many people cope with their emotional distress and anxiety with food, drugs or alcohol.”

Most studies show about 50 per cent of participants maintain healthy lifestyle changes, and while cost, access and perceived benefits are factors, social isolation and emotional distress play a critical role in the behaviours we choose and the behaviours we avoid.

Our social and emotional health may also have a downstream effect on our physiology.

“Chronic mental stress and persistent negative emotions can significantly impact cardiovascular health,” Fontana writes.

Chronic anger, for instance, can trigger dangerous heart rhythm disturbances. “These effects are mediated through activation of the hypothalamic-pituitary-adrenal axis and autonomic nervous system, leading to elevated blood pressure, heightened platelet and immune responsiveness, and increased inflammation and oxidative stress.”

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Head of electrophysiology research, Peter Kistler.
Head of electrophysiology research, Peter Kistler.
© Penny Stephens
Similarly, a lack of social and emotional support, loneliness and depression elevate the risk of cardiovascular disease and cognitive decline because they create a proatherogenic state (the forming plaques in the arteries) from too much cortisol, impaired vagal function, reduced heart rate variability and inflammation.

Professor Peter Kistler, the head of clinical electrophysiology research at the Baker Heart and Diabetes Institute, says: “Overall, these are excellent tips for to follow to optimise one’s cardiometabolic health.”

He notes, however, that the effects of stress, relationships and air pollution on cardiometabolic health are based on observational studies, which are thwarted by confounders and difficult to control for.

“Nonetheless, there are scientifically plausible reasons why stress can have a negative impact on cardiometabolic health through activation of the sympathetic nervous system and cortisol, insulin release,” says Kistler, who is conducting the first randomised controlled trial exploring the benefits of regular yoga on heart health.

Fontana believes that the teaching of nutrition and healthy cooking, physical activity, how the body works and strategies to manage emotional health should be taught from primary school.

“Mindfulness-based stress reduction and cognitive therapy, particularly when combined with slow breathing exercises and artistic/philosophical spiritual practices, can effectively alleviate psychological and emotional stress, anxiety, and depression and promote human flourishing,” he says.

“Nurturing deep connections with family and friends through insight, empathetic communication, and forgiveness, marked by altruism and compassion, are paramount in enhancing the plasticity of wellbeing.”

It is only through education and a shift in healthcare away from the “sick-care medical system” to a holistic approach that, he believes, we can stop the rising prevalence of chronic conditions, including cardiometabolic disease, in Australia.

“Zero risk is impossible, but we have a better understanding of how we can markedly reduce the risk of developing many current diseases,” he says. “The idea that as you get older you’re going to develop some disease and going to have to take medication is not

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Successfull ACTION day presentation in front of 300-400 interventional cardiologists of Australia and more than 1000 audience in Sydney today.

Because of the overwhelming POSITIVE response to our previous post, we have decided to extend the heart disease awareness campaign, so that it can be easily understood by the majority of our population.

Pulse Cardiac Care offers high-quality 2D Echocardiography, Stress Testing (including Stress Echocardiography), 24-hour HOLTER, 24-hour BP monitoring, Angiography with Stenting, Transoesophageal Echocardiography services and specialist Cardiology Consultations with minimal wait times.

Please contact us for further information at

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Pulse Cardiac Care offers high-quality 2D Echocardiography, Stress Testing (including Stress Echocardiography), 24-hour HOLTER, 24-hour BP monitoring, Angiography with Stenting, Transoesophageal Echocardiography services and specialist Cardiology Consultations with minimal wait times.

This Heart Week we are spreading awareness of heart disease and tips on staying heart-healthy Please contact us for further information at

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